How Has COVID-19 Affected the Global Fight Against Tuberculosis?

[This document is a one of a series of discussion notes addressing fundamental questions about the global health. Its purpose is to transfer scientific knowledge to the public conversation and decision-making process. The papers are based on the best information available and may be updated as new information comes to light.]

Written by Isabelle Munyangaju, Alberto García-Basteiro, Elisa López-Varela and Anna Saura Lázaro (ISGlobal), the paper discusses how the COVID-19 pandemic has been a significant setback for tuberculosis (TB) programmes around the world, particularly in low- and middle-income countries (LMICs) where the disease burden is the highest. The impact has been on multiple dimensions, including TB service demand, access, supply chain, number of TB cases identified and notified, TB incidence, mortality and financing. The investment made in COVID-19 research was in 2020 113 times higher than that devoted to TB research.

In the same way COVID-19 response leverages existing TB infrastructure and resources, as we progress toward COVID-19 control TB programs in LMICs can move to integrate strategies and services of both diseases in a synergistic manner. Both infections are respiratory in nature and have similar health prevention and control strategies.

Additionally, the World Health Organization (WHO) has been compiling case studies of innovative responses that have succeeded in mitigating or reversing negative impacts of the pandemic to provide examples to affected countries. For example:

• The use of COVID-19 vaccination programmes to screen for TB.
• Sustaining real-time surveillance to improve TB detection.
• Digital interventions to support treatment adherence and reduce health facility visits.

The paper concludes that TB needs to see a simliar or higher political commitment that was experienced with COVID-19.

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